LE and a1-PI reflect the clinical and biological features of the asthenic symptom-complex which develops within the endogenous process. Normal/reduced activity of LE accompanied by the increased activity of a1-PI is the best predictor of bestim efficacy in terms of reduction of asthenic symptoms.
Актуальность настоящего исследования определяется отсутствием в современных систематиках и классификациях психических заболеваний четких дифференциально-диагностических критериев эндогенной астении, что существенно затрудняет адекватную квалификацию, диагностическую и прогностическую оценку и влияет на выбор терапии данных состояний.Цель исследования: изучить психопатологические особенности астенических расстройств в стадии ремиссии приступообразно-прогредиентной шизофрении.Материал и методы: обследовано 63 пациента мужского пола в возрасте 23-58 лет с диагнозом приступообразно-прогредиентной шизофрении в стадии ремиссии (не менее 6 месяцев) с преобладанием в клинической картине астенических расстройств. Применялись следующие методы: клинико-психопатологический, психометрический (с использованием шкал PANSS, SANS, CDSS, VAS-A, MFI-20), статистический.Результаты: на основании детального анализа астенической симптоматики выделено два типа эндогенной астении: аффективно-астенический тип (n = 22; 34,9%) и негативно-астенический тип (n = 41; 65,1%). Негативно-астенический тип включал в себя два подтипа: I подтип -негативно-астенический классический (n = 35; 55,6%), II подтип -негативно-астенический со сверхценными ипохондрическими идеями (n = 6; 9,5%).Выводы: выделение нескольких типов астенических расстройств в ремиссии эндогенного процесса является значимым в плане синдромальной диагностики, что может послужить одним из факторов, позволяющих уточнить прогноз течения заболевания.Ключевые слова: шизофрения; ремиссия, астения; типология. Для цитирования: Якимец А.В. Типология астенических расстройств в ремиссии приступообразно-прогредиентной шизофрении. Психиатрия. 2019;17(2):16-22. Конфликт интересов отсутствуетThe relevance of this study is defined by the absence of clear differential and diagnostic criteria of endogenous asthenia in modern systematics and classifications of mental illnesses which significantly complicates appropriate qualification, diagnostic understanding, preliminary assessment and therapy of these conditions.The purpose of the study: the research of psychopathological characteristics of asthenic disorders in patients with attacklike progressive schizophrenia in remission.Material and methods: 63 male patients aged 23-58 with attack -like progressive schizophrenia in remission (at least 6 months), with asthenic disorders prevailing in clinical picture, were examined. During the examination, the following methods were used: clinico-psychopathological, psychometric (with the use of scales PANSS, SANS, CDSS, VAS-A, MFI-20), statistical.Results: based on the detailed analysis of asthenic symptomatology, its clinical heterogeneity in asthenic symptoms was revealed. It allowed to allocate two types of endogenous asthenia: affective-asthenic type (n = 22; 34,9%) and negative-asthenic type (n = 41;65,1%), which included two subtypes: the 1st subtype -negative-asthenic classical (n = 35; 55,6%), the 2nd subtype -negative-asthenic with overvalued hypochondriac ideas (n = 6; 9,5%).Conclusions: The allocation...
IntroductionInflammation is now known to be a key factor in the development of schizophrenia. In this regard, the study of the pathogenic role of inflammation in the early stages of schizophrenic process is of particular importance, making it possible to assess its activity and to predict the development of the disease.ObjectivesTo compare the dynamics of inflammatory markers in blood of first-episode psychosis (FEP) patients and people at risk signs for schizophrenia in the course of the treatment. Juvenile depression (JD) with attenuated symptoms of schizophrenic spectrum (ASSS) was investigated as a risk group.MethodsThe patients aged 17-25 years (20 people, of which 10 FEP patients (F20) and 10 JD with ASSS ones (F32.1-2, F32.38, F32.8)) were examined at admission to the hospital and at discharge. The controls consisted of 10 healthy volunteers. Symptom severity was collected using PANSS, SOPS, SANS, HDRS. The inflammation markers (TNF-α, IL-6, IL-10, leukocyte elastase (LE), CRP, α1-proteinase inhibitor (α1-PI), anti-S100-beta antibodies) were determined in blood.ResultsAn increase of inflammatory markers in both groups compared to controls was found (p<0,05). The highest values of IL-6, LE, CRP, α1-PI and anti-S100-beta antibodies in FEP patients were revealed (p=0,03). After the treatment, the positive trend of inflammatory markers in FEP patients (p<0,05), but not in JD with ASSS patients was detected (except LE activity, p<0,05).ConclusionsThe results confirm the pathogenic role of inflammation in the development of endogenous mental disorders. The inflammatory markers studied reflect the activity of the pathological process in the early stages of schizophrenia.DisclosureNo significant relationships.
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